Causes of epigastric abdominal pain

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Diffuse Abdominal Pain
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hilda Mahmoudi M.D., M.P.H.[2]


Epigastric pain is pain localized in the upper central region of the abdomen. Sudden onset of epigastric pain is suggestive of pancreatitis, especially when it radiates to the back and is associated with anorexia, nausea and vomiting. Subacute or chronic epigastric pain is challenging to assess. In many situations, physicians are unable to accurately diagnose such pain solely based on history and physical examination.[1][2][3] A common cause of epigastric pain is dyspepsia which may be associated with abdominal fullness, bloating or nausea.


Life Threatening Causes

Life-threatening causes include conditions which result in death or permanent disability within 24 hours if left untreated.

Causes of epigastric abdominal pain developed by

Common Causes

Causes of epigastric abdominal pain developed by

Causes by Organ System

Cardiovascular Myocardial ischemia, ruptured aortic aneurysm
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect No underlying causes
Ear Nose Throat No underlying causes
Endocrine Acute pancreatitis, pancreatitis
Environmental No underlying causes
Gastroenterologic Bile duct tumor, cholecystitis, cholecystolithiasis, delayed gastric emptying, dyspepsia, esophageal perforation, gallbladder cancer, gastric tumors, gastritis, gastroesophageal reflux disease (GERD), colon cancer, hepatic tumors, hepatomegaly, irritable bowel syndrome, pancreatic tumors, pancreatitis, peptic ulcer disease, perforated duodenal ulcer, postcholecystectomy syndrome, ruptured spleen, splenic infarction, ulcerative colitis
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease

Chronic infection, giardiasis, intestinal parasite, tuberculosis

Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Hepatic tumors, lymphomas, pancreatic tumors, renal cell carcinoma
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Basal pneumonia, pleuritis, pulmonary embolism
Renal/Electrolyte pyelonephritis, renal cell carcinoma
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma Ruptured spleen
Urologic No underlying causes
Miscellaneous Referred pain

Causes by Organ System developed by, Copyleft 2013

Causes in Alphabetical Order

Causes of epigastric abdominal pain developed by


  1. Heikkinen, M.; Pikkarainen, P.; Eskelinen, M.; Julkunen, R. (2000). "GPs' ability to diagnose dyspepsia based only on physical examination and patient history". Scand J Prim Health Care. 18 (2): 99–104. PMID 10944064. Unknown parameter |month= ignored (help)
  2. Thomson, AB.; Barkun, AN.; Armstrong, D.; Chiba, N.; White, RJ.; Daniels, S.; Escobedo, S.; Chakraborty, B.; Sinclair, P. (2003). "The prevalence of clinically significant endoscopic findings in primary care patients with uninvestigated dyspepsia: the Canadian Adult Dyspepsia Empiric Treatment - Prompt Endoscopy (CADET-PE) study". Aliment Pharmacol Ther. 17 (12): 1481–91. PMID 12823150. Unknown parameter |month= ignored (help)
  3. Bytzer, P.; Hansen, JM.; Havelund, T.; Malchow-Møller, A.; Schaffalitzky de Muckadell, OB. (1996). "Predicting endoscopic diagnosis in the dyspeptic patient: the value of clinical judgement". Eur J Gastroenterol Hepatol. 8 (4): 359–63. PMID 8781906. Unknown parameter |month= ignored (help)


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